Isolation pt's and spreading diseases

[chenoaspirit, ASN, RN]

Just wondering what you think of this. One night I had a pt with TB, one with Bacterial Meningitis, and a baby. Last night I had an immunosuppressed pt and another with r/o TB. I just dont think I should be going from one room to the other, even though I DO wash my hands. At some point, I have to hold that baby after pulling TB pt up in bed, etc. My clothes are contaminated, even if my hands have been sanitized. My nurse manager told us that the only patient you have to worry about is an immunosuppressed pt such as chemo pt's, not babys (their immune system is stronger than ours) WHAT! Babies do not have the acquired immunity that adults have. We all disagree about it, but nothing we can do because we dont give out the team assignments. I am just uncomfortable taking care of babies who are already sick and at risk while carrying such deadly germs on my clothes. Opinions?

[Mulan]

Do you have an infection control nurse at your hospital that you can ask?

You have to take care of adults and babies? I don't think you should have to do that in the first place, I guess you don't have a pediatric floor.

[RNfromMN, BSN, RN]

Huh?:selfbonk:

I'm just a nursing student, but I'm pretty sure you're right about baby's immunes systems being weaker than ours...isn't that a no-brainer? Isn't that why babies are constantly having ear infections & colds? But, let's say for arguments sake that infants do have a stronger immunity system than ours:icon_roll ...I think another piece of the puzzle is that when babies acquire certain illnesses (TB & meningitis being classic examples), the long-term effects are much more devastating than if adults were to acquire the same illness.

Who's making up your assignments? When I worked as a CNA, the nurse that had actually worked the floor the shift before made up our assignments. CNAs were never allowed to work with say, one pt that had pneumonia & an infant on the same shift. You can bet the mother of that baby would certainly have something to say if she knew about it!

[suzyRN]

I think every hospital has infection issues like this. I think that alot of the times the nurse that does the assignments is often rushed and doesn't have time to take all these issues into consideration. i would contact infection control to see what kind of policies are out there. Also- if that was my baby i would definately have issues with it. TB rooms are droplet precautions but I always use the contact gowns in addition to the PAPR. Do you have issues with CNAs, dietary, and housekeeping not following isolation requirements. It drives me nuts because they actually come into contact with more pt's than we do! Any thoughts?

[chenoaspirit, ASN, RN]

Well, the previous shift nurse is the one who makes up the assignments. We questioned her about it and she still made no adjustments, saying that the only patients we have to worry about are the immunosuppressed patients. But last night I HAD an immunosuppressed patient AND the TB patient. I am not sure where/who I need to contact. And if I do, I will create waves, but the patients' safety is my concern. We dont have a Peds floor. I work on a med-surg floor and all peds patients come to our floor. I would rather either have all the babies and immunosuppressed patients OR all the TB, meningitis, etc. I guess if they backed up and re-did the assignments, it would make them look like they "didnt know what they were doing" which is sad. We all make mistakes and overlook things, it doesnt reflect our intelligence. But they are always right, no matter what. Im having a hard time with it though because Im scared to death I am going to carry some deadly disease to another patient and I just cant live with that on my conscience. What would you do?

[chenoaspirit, ASN, RN]

Oh and also....Ive seen MANY times the RT use their stethoscope on the TB patient, then go and use the same one on the baby! Without at least sanitizing first! We have disposable ones, but no one will use them.

[suzyRN]

i would contact infection control and maybe even the DON. Tell them that you think this could be easily fixed. if they act like its nothing maybe find another job?

[live_crow]

Could you just use disposable gowns and gloves with the rule out TB patient and take them off before attending to other patients? This should be fairly basic if they are on contact precautions.

[Pam I Am RN]

I had 2 MRSA, 1 C-Diff and 1 Neutropenic. When I told my unit director she said "we have contact precautions in place so we can do that". Legally yes, ethically it's just wrong.

[sharona97, BSN, RN]

I received pertussis from an infant less than 2 months old. A very viral strength. I experienced a near death experience myself when I went undiagnosed for 4 months. Some rulemakers need to think outside the box, right? Currently because of severe complications and 3 resp distress episodes over a period of 6 years I now am a disabled nurse. I can't run my buns off anymore like I used to. They did a VQ Scan to R/O embolis which was neg but the reort shwed an obstruction, the treating doc told me "well we know you don't have any clots" and blew off the obstruction. I really appreciate your thoughts.

[lilemon27]

Every hospital is so different in how they decide on isolation precautions. Where can I find the standards for these?